Laserfiche WebLink
SAN 10 A Q U I N Environmental Health Department <br /> % I ,Y, PUBLIC RECORDS RELEASE APPLICATION <br /> Greatness grows here. <br /> SUBMIT BY EMAIL <br /> EHD LOG NUMBER: <br /> APPLICANT: Tim Cuellar BUSINESS/AGENCY:Advanced GeoEnvlronmental inc <br /> ADDRESS: 837 Shaw Road, CITY/STATE/ZIP:Slncklon CA 95215 <br /> PHONE(1): 209-323-6515 PHONE(2):209-467 1006 FAX OR E-MAIL: t(-,Lle1Ian'd)advgeoenvcom <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review the requested records. <br /> SIGNATURE OF APPLICANT DATE u-22 201, <br /> 1. List up to ten addresses in the space below. Address ranges WILL NOT be accepted. Select the type(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138, mail to the <br /> address indicated below, or email to info(aa�slcehd.com. Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2. For assistance in identifying the nature and content of EHD records, please contact EHD at the number noted below. <br /> 3. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately ten (10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$152 deposit prior to review. <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(EXCLUDING HOLIDAYS) <br /> Electronic Information: x❑ List ❑x Map— Description: <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS <br /> HEALTH DEPARTMENT ( p y 9 p ) EHD USE ONLY <br /> FILES (Specific addresses only,address ran es will not be acce ted <br /> Fx Underground Tank(UST) Street# Street Name City <br /> Cleanup Site(LOP) ❑CONSUMER <br /> X❑Other Cleanup Site(Non-LOP) ' 31411 K a s s o n Road Tracy <br /> E❑Hazardous Waste DAIRY <br /> ❑Tiered Permitted Facility 2 <br /> FX Aboveground Tank <br /> Q UST (Monitoring/Removal) ❑PWS <br /> Q Hazardous Materials 9 <br /> Spill/Release Response <br /> WATER QUALITY <br /> Solid Waste Facility/Vehicle 4 ❑ <br /> ❑Food Facility <br /> ❑Pool/Spa ❑SITE MITIGATION <br /> ❑Dairy 5 <br /> E]Land Use Application Sites <br /> Septic Pumper Truck/ HOUSING <br /> 6 <br /> Yard/Chemical Toilets <br /> Wastewater Treatment Plant ❑CUPA <br /> Housing Abatement 7 AST/HM/HW <br /> Motel/Hotel <br /> Chicken Ranch/Dog Kennel ❑C.UPA <br /> B <br /> Medical Waste Facility UST <br /> Tattoo/Body Piercing <br /> ❑Souo Waste <br /> Waste Tire 9 <br /> xj Complaint <br /> Other(Please Specify): ❑ACCOUNTING <br /> 70 <br /> ***BOXED AREA-EHD USE ONLY <br /> ❑ Records provided by Staff-PPR Complete. staff Name: EHD 48-06 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />